| Background. Obesity is a major public health problem. An environment characterized by numerous fast food outlets gives individuals easy access to energy-dense, nutrient poor foods, which may play a role in the development of obesity. This investigation examined the role of fast food intake and the availability of fast food restaurants in influencing diet and overweight among adolescents.;Methods. In 1989, 812 adolescents aged 12 to 18 years participated in CLUE II, a cohort study in Washington County, MD. A food frequency questionnaire, weight, height, blood pressure, and a blood sample were collected. Residential addresses were mapped using GIS methodology. In 2003, 221 participants completed follow-up questionnaires providing data on fast food intake, weight and height. Multivariable analyses of covariance and regression models were used to assess the associations between adolescent fast food intake, dietary habits, and overweight in adolescence and young adulthood. Multilevel models were used to examine the association between the number and type of food outlets within census block groups where adolescents resided, fast food intake, and overweight.;Results. Frequent fast food intake was associated with poor dietary habits. Nine percent of adolescents were overweight (BMI ≥ 95th percentile). Overweight adolescents were more likely to have high cholesterol (OR=2.2, 95% CI: 1.1, 4.4) and high blood pressure (OR=4.4, 95% CI: 2.5, 7.9) when compared to non-overweight adolescents. The frequency of eating out in adolescence and adulthood were positively correlated (rho=0.22, p < 0.05). Eating fast food weekly was associated with overweight in adolescence (OR=1.2, 95% CI: 1.0, 1.3) and increases in fast food intake over the 14-year period were associated with obesity in young adulthood (OR=1.2, 95% CI: 1.0, 1.5). Adolescents residing in lower socioeconomic areas were more likely to be overweight and consumed more fast food than adolescents in higher socioeconomic areas.;Conclusions. Regular fast food consumption was associated with poor diet habits and overweight. Fast food restaurant use tracked from adolescence into adulthood, indicating the early establishment of life-long eating habits. Policies that limit the availability of fast food and provide healthy low cost alternatives may be effective in reducing adolescent overweight. |
